Psychological treatments for stimulant misuse, comparing and contrasting those for amphetamine dependence and those for cocaine dependence
- PMID: 19307968
- PMCID: PMC2825894
- DOI: 10.1097/YCO.0b013e32832a3b44
Psychological treatments for stimulant misuse, comparing and contrasting those for amphetamine dependence and those for cocaine dependence
Abstract
Purpose of review: The aim is to compare and contrast psychological treatments for amphetamine and cocaine dependence.
Recent findings: Stimulant dependence, in the form of cocaine or amphetamine/methamphetamine dependence, is prevalent worldwide, and their ratio may vary across different countries and regions of countries. The treatment of stimulant disorders has greatly advanced in recent years, and scientific evaluation of behavioral therapies, using randomized clinical trials designs and a stage-wise approach, have demonstrated the safety and efficacy of interventions. Psychological interventions such as cognitive behavioral therapy and contingency management for cocaine and methamphetamines use disorders are well tolerated and moderately effective in achieving drug abstinence. There is evidence that contingency management interventions can help to improve retention in treatment and, in turn, other treatment outcomes. Although there are important differences in the neuropsychiatric and medical consequences of cocaine and amphetamine use disorders, there is currently no evidence for a differential treatment effect of any psychosocial treatment in the management of these disorders.
Summary: As there are no Food and Drug Administration-approved medications for the treatment of these disorders, psychological interventions form the basis of their treatment. More research is needed to address the specific psychosocial needs of cocaine and amphetamine-dependent individuals in order to improve their treatment outcomes.
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This is the most recent estimate of stimulant users in the world, which shows differences in the prevalence of cocaine and amphetamine use disorders in different countries.
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This meta-analysis of 12 studies shows a moderate effect size of voucher-based contingency management for the treatment of cocaine dependence.
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